Serologic characterization of patients with two episodes of acute viral hepatitis.

Since testing for serologic markers of hepatitis B virus (HBV) became routine, we have observed in our hospital 28 patients with two distinct episodes of illnesses, each of which was compatible with acute viral hepatitis. We found no distinctions between the first and second bouts with respect to clinical characteristics, abnormalities of liver function or epidemiologic background. Testing of specimens obtained during each of the two acute episodes, the interval between the two episodes and the period subsequent to the second by sensitive procedures for hepatitis B surface antigens (HBsAg) and their corresponding antibodies (anti-HBs) permitted the following classification: 13 of 28 patients experienced first bouts serologically classifiable as due to HBV; 11 patients had second bouts serologically classifiable as due to HBV; 2 patients had two episodes both which were serologically indeterminate; and 2 patients had two bouts neither of which appeared compatible with HBV infection by present criteria. No patient had a second episode for which the HB2Ag and anti-HBs data suggested HBV recurrence or reinfection. This evidence does not favor the speculation that HBV can account for repeated episodes of acute icteric hepatitis.